| NPI | 1619020179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 2007-00124) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 30740) |
| 207R00000X Internal Medicine (Licence: NC 2007-00124) | |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2011-06-22 |